| NPI | 1598835480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA7178) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA00422) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2020-11-23 |